Provider Demographics
NPI:1326107962
Name:KATZ, MERRIDESSA (LLP)
Entity Type:Individual
Prefix:MRS
First Name:MERRIDESSA
Middle Name:
Last Name:KATZ
Suffix:
Gender:F
Credentials:LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 COLUMBIA AVE E
Mailing Address - Street 2:STE 113A
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-3761
Mailing Address - Country:US
Mailing Address - Phone:269-962-2722
Mailing Address - Fax:269-964-8484
Practice Address - Street 1:131 COLUMBIA AVE E
Practice Address - Street 2:STE 113A
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49015-3761
Practice Address - Country:US
Practice Address - Phone:269-962-2722
Practice Address - Fax:269-964-8484
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301012438103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist